羟乙基淀粉130/0.4对慢性阻塞性肺病患者进行液体复苏的临床研究  

The clinical research of voluven for fluid resuscitation in Chronic obstructive pulmonary disease patients

作　　者：黄磊[1] 张卫星[1] 朱仲生[1] 姜春玲[1] 罗华[1] 蔡文训[1] 

机构地区：[1]北京大学深圳医院ICU,518036

出　　处：《中国医师进修杂志》2006年第12期11-13,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的观察羟乙基淀粉130/0.4(万汶)对慢性阻塞性肺病(COPD)患者进行液体复苏的有效性和安全性。方法40例COPD患者,气管插管或机械通气后出现血压下降,随机分配到万汶组和林格液组,各20例。监测复苏时间、复苏液体量、血液流变学、凝血功能和肾功能以及不良反应。结果万汶组和林格液组输液量分别为(1535±380)ml和(2150±427)ml,复苏时间分别为(5.21±1.94)h和(6.48±2.36)h,P<0.05。万汶组血液流变学参数改善差异有统计学意义(P<0.01),而林格液组变化差异无统计学意义(P>0.05);两组的凝血功能和肾功能在复苏前后差异无统计学意义(P>0.05);林格液组出现3例下肢水肿加重。结论万汶能快速有效地稳定血流动力学,改善血液流变学,可能更有利于器官灌注和组织氧合,故可首先考虑用于COPD患者的液体复苏。Objective To evaluate the efficacy and safety of voluven （ hydroxyethyl starch 130/ 0.4 ） for fluid resuscitation in Chronic obstructive pulmonary disease （COPD） patients. Methods Forty tracheal intubated, mechanically ventilated COPD patients with blood pressure dropping were randomly divided into voluven group （20 patients） and Ringer solution group （20 patients ）. The time taken to achieve cardiovascular stability, the resuscitative fluid volume, hemorheology, blood coagulation, renal function and adverse events were monitored. Results For voluven and Ringer solution, the fluid volume was （ 1535±380 ） ml and （ 2150±427 ） ml and the resuscitative time was （5.21±1.94 ） h and （6.48±2.36） h respectively （ P 〈 0.05 ）. The hemorheology parameters were improved in voluven （P 〈 0.01 ）, but not in Ringer solution （P 〉 0.05 ）. Blood coagulation and renal function were not changed after fluid resuscitation（ P 〉 0.05 ）. The edema of lower extremity was worse in 3 patients of Ringer solution group. Conclusion Voluven could effectively and quickly maintain hemodynamie stability, improve the hemorheologieal status. It may improve organ perfusion and tissue oxygenation. Voluven should be eor/sidered firstly for fluid resuscitation in COPD patients.

关 键 词：羟乙基淀粉 慢性阻塞性肺病 液体复苏 

分 类 号：R563.9[医药卫生—呼吸系统]